[Vertebral tuberculosis in Gabon. Anatomo-clinical aspects, diagnostic and therapeutic problems, 107 cases from 1976 to 1986].

This retrospective study covers a period of 10.5 years (february 1976 to november 1986). It concerns 107 patients who contracted tuberculous spondylitis and originated from different provinces of Gabon. The authors report their experiences in order to emphasize the frequency of the disease, diagnostic and therapeutic problems. In Gabon, tuberculosis of the spine occupies the third position (3%), after the pulmonary form (90%) and ganglionic form (3.8%). In also represents 83.6% of the osteoarticular tuberculosis. The average age is 22 years, 55% of the patients were less than 20 years. The zone of maximum predilection, in decreasing order, is thoracic spine (36.4%), lumbar spine (33.6%), thoraco-lumbar region (10.3%). The 107 patients totalized 257 vertebral bodies destroyed (an average of 2.4 bodies per patients). On the clinical field the sick seek advice at an advance stage of the disease with gibbosity (38.3%) and neurologic deficits (21.5%). The diagnosis proof often followed the therapeutic results. There were three therapeutic modalities: medical (all patients), surgical (6 patients) and orthopedic (44 patients). The therapeutic indications improved with the available of more material and qualified staff. In children the treatment remains classic. The authors discuss the surgical indications in adults. The therapeutic results in patients treated and followed for over one year were satisfactory. Unfortunately, most patients were lost to follow-up. They suggest public health means of decreasing the frequency of the disease.